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GENERAL ARTICLE

Intravenous Lidocaine After Tracheal Intubation Mitigates Bronchoconstriction in Patients with Asthma

Michael Adamzik, Dr med^*, Harald Groeben, Prof Dr med^*, Ramin Farahani, Dr med^*, Nils Lehmann, Dr rer nat, and Juergen Peters, Prof Dr med^*

From *Klinik für Anästhesiologie und Intensivmedizin; and Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany.

Address correspondence and reprint requests to Michael Adamzik, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany. Address e-mail to michael.adamzik{at}uni-essen.de.

BACKGROUND: Although prophylactic IV administration of lidocaine attenuates the response to a variety of inhalation challenges, its effect on airway resistance after endotracheal intubation in patients with asthma is unclear. We tested the hypothesis that IV lidocaine attenuates intubation-evoked bronchoconstriction in patients with asthma.

METHODS: Thirty patients with asthma (age 49.1 ± 15.6 yr [mean ± sd]) undergoing intubation after standardized anesthetic induction (etomidate 0.3 mg/kg, fentanyl 5 µg/kg, rocuronium 0.6 mg/kg, 50% nitrous oxide) were studied. Airway resistance was measured immediately after intubation and 5, 10, and 15 min later. Five minutes after intubation, either lidocaine (2 mg/kg IV for 5 min, followed by 3 mg · kg^–1 · h^–1 for 10 min) or saline was administered.

RESULTS: Airway resistance immediately after intubation averaged 23 ± 12 cm H₂O · s · L^–1. Airway resistance further increased (+38%) after administration of saline, but decreased (–26%, P < 0.004) to less than the initial values after lidocaine.

CONCLUSIONS: IV lidocaine given after endotracheal intubation mitigates bronchoconstriction in patients with asthma.

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